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Organization

RALPHVAN HEALTHCARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL OMOMO (CEO)
(631) 533-2990
Entity
Organization

Contact information

Practice address
7400 METRO BLVD STE 215, EDINA, MN 55439-2321
(631) 533-2990
Mailing address
7400 METRO BLVD STE 215, EDINA, MN 55439-2321
(631) 533-2990

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
10/11/2023
Last updated
03/17/2026
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